"Each month, the Penn Physician Blog features a review of recent journal publications by clinical researchers in the Department of Traumatology, Surgical Critical Care and Emergency Surgery at the University of Pennsylvania."
During the Fall of 2021, clinician researchers in the Penn Department of Traumatology, Surgical Critical Care and Emergency Surgery concentrated on their core interests, transcending the COVID pandemic to report on issues, concerns and findings of great relevance to trauma surgeons, including the following featured articles, which explore the incidence and healthcare system burden of incisional hernia after trauma laparotomy, the impact of gentrification on shooting deaths in disadvantaged neighborhoods, and the value of reciprocal learning between civilian and military surgeons.
Arturo J. Rios-Diaz, MD; Jessica Cunning, MBA; Jesse Y. Hsu, MS, PhD; Omar Elfanagely, MD; Joshua A. Marks, MD; Tyler R. Grenda, MD, MS; Patrick M. Reilly, MD; Robyn B. Broach, PhD; John P. Fischer, MD, MPH
A team of clinician researchers from the divisions of Trauma and Plastic Surgery at Penn have performed a retrospective study in 35,666 patients to identify patient-level, perioperative, and novel postoperative factors associated with incisional hernia (IH) after traumatic laparotomy. Median time to IH was 1.4 years; most IHs occurred within 5 years (90.6 percent), accumulating to a 10-year rate of 11.1 percent. Supplemental findings identified obesity, intestinal procedures, and repeated disruption of the abdominal wall as risk factors, supporting the application of preemptive strategies at the time of re-operation to lessen IH incidence.
Dane Scantling, DO, Y Whitney Orji, BS, Justin Hatchimonji, MD, Elinore Kaufman, MD, and Daniel Holena, MD
A report from Penn Trauma earlier this year highlighted the effect of gentrification on the neighborhoods surrounding trauma centers, finding that shootings in Philadelphia moved out of gentrified areas and concentrated in non-gentrified ones, and noting evidence that this pattern of change paradoxically resulted in an increased clustering of shootings around trauma centers in non-gentrified areas and that evidence suggests that an increase of only 1 mile from a trauma center increases shooting mortality up to 22 percent.
Divyansh Agarwal, MS, Clyde F. Barker, MD, Ali Naji, MD, PhD, and C. William Schwab, MD
As part of the U.S. National Library of Medicine Michael E. DeBakey Fellowship in the History of Medicine, surgeons from Penn Trauma and the Department of Surgery conducted archival research to shed light on the mutual benefits and promise of shared lessons between civilian surgery and the military system. Using historical case studies, the authors highlight the need for immersive programs where surgeons from the military and civilian sectors can gain exposure to the techniques, expertise, and institutional knowledge the other domain provides.
New Research from Penn Trauma
The following represents a selection from various publications of new studies and reports from providers in the Department of Traumatology, Surgical Critical Care and Emergency Surgery at the Perelman School of Medicine: